| Objectives:By analyzing retrospectively the medical records of patients suffering the disease of Primary liver Cancer (PLC), we gained the general information and TCM four diagnostic information and established TCM Information Database of PLC initially in order to probe the features and distribution law of TCM syndromes.Methods:We collected 798 medical records of patients who suffered PLC in Hubei hospital of TCM from 2004.6 to 2009.12,and kept detailed records of their general data,chief symptoms,accompanying symptoms,tongue proper,tongue coating,pulse condition and signs,laboratory examinations on admission,the name of disease in TCM,TCM syndrome type,clinical staging complications,etiology,Survival time of patients who died, and so on. Then we used the tool named SPSS17.0 for data analyses, where the chi-square test,analysis of variance,LSD test,Games Howell test,Survival analysis,Log-rank test, Breslow test and Kaplan-Meier method were utilized.Results:823 medical records were collected together, of which 798 were valid,189 repeated. The actual number of patients was 609. They were mainly middle and advanced cancer patients and the stage ofâ…¡a or above accounted for 95.6%.There are nine names of disease ascertained after investigation and calculation:Ganji,Ganai,Guzhang,jaundice,Blood disorder,hypochondriac pain,Xulao,diarrhea and Jizheng, among which the Ganji accumulated the highest percentage of 42.1%. In this study, QSBS syndrome accounted for the highest proportion of 50%, followed by LSSD syndrome type, accounting for 21.1%, whose chief complaints were mainly dim pain in liver area, abdominal distension. They two accounted for 46.5%. While the most prevalent signs were the liver enlargement and liver mass and ascites syndrome which accounted for 39.5% and 37.7%. Of tongue proper pink tongue had the largest proportion, accounting for 41.2%. Thin white tongue coating have the highest proportion,33.3%, and of pulse condition, taut pulse is the most,56.1%. Complications with infection and ascites are most prevalent, accounting for 51% and 28.9%.When it came to the etiology, there are 650 patients related with viral hepatitis, accounting for 81.45%, of which 644 patients were hepatitis B, accounting for 80.70%. In hepatitis B-related PLC patients, QSBS syndrome and LSSD syndrome were the most prevalent, accounting for 71.74%.The overall average of AFP was 30333.3751ng/ml, ALB was 32.6663g/l, and TBIL 64.6313mmol/l. The PTA level was 63.5012% and NEU% 73.6280%, compared with the normal level, P=0.000, indicating significantly different.The levels of AFP,ALB,TBIL,PTA (prothrombin activity),Cr and the ratio of neutrophil levels were different, P<0.01, indicating the difference is statistically significant.140 patients died during hospitalization and the range of time distribution from diagnosis to death was 0.5 months to 60 months (five years). The average survival time was 7.5 months and median survival time 4.0 months,75% of the patients died 6 months after diagnosing,90% of the patients died 12 months (one year) after diagnosing.5-year survival rate was 5%. The Kaplan-Meier method analysis showed that there was a significant difference among the survival time of patients with different TCM syndromes, P= 0.000. Patients'syndrome of spleen deficiency and water stopping type had the shortest average survival time (0.5 months). And the longest average survival time (21.3 months) belonged to patients whose syndrome type was the failure of spleen to control circulating blood.Conclusions:1. In this study, PLC had the 6.6:1 F:M ratio, which was highest compared with the reported ratio of 2-5:1. Age of the onset was mostly 40 to 60 years old, which was similar to the reports in literatures. There was 80.7% of PLC patients were related with being infected by hepatitis B virus, which was consistent with the reports in literatures. It indicated that hepatitis B virus infection played a very important role in the etiology of PLC.2. The main syndromes of Hepatitis B-related PLC patients are QSBS and LSSD, which showed that emotional factors also played a important role in the pathogenesis of liver cancer.3. The patients who belonged to the syndrome of Dampness and Heat accumulated in the body,spleen deficiency and water stopping,phlegm and blood stasis,Failure of Spleen to Control Circulating Blood and Yin deficiency of liver and kidney had very poor liver function,coagulation function and renal function, compared with QSBS and LSSD. 4. The 5-year survival rate of patients who died during hospitalization was 5%, which was close to clinical reports. |
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